Doctor Referral of Overweight People to a Low-Energy Treatment (DROPLET) in primary care using total diet replacement products: a protocol for a randomised controlled trial

BMJ Open. 2017 Aug 4;7(8):e016709. doi: 10.1136/bmjopen-2017-016709.

Abstract

Introduction: The global prevalence of obesity has risen significantly in recent decades. There is a pressing need to identify effective interventions to treat established obesity that can be delivered at scale. The aim of the Doctor Referral of Overweight People to a Low-Energy Treatment (DROPLET) study is to determine the clinical effectiveness, feasibility and acceptability of referral to a low-energy total diet replacement programme compared with usual weight management interventions in primary care.

Methods and analysis: The DROPLET trial is a randomised controlled trial comparing a low-energy total diet replacement programme with usual weight management interventions delivered in primary care. Eligible patients will be recruited through primary care registers and randomised to receive a behavioural support programme delivered by their practice nurse or a referral to a commercial provider offering an initial 810 kcal/d low-energy total diet replacement programme for 8 weeks, followed by gradual food reintroduction, along with weekly behavioural support for 24 weeks. The primary outcome is weight change at 12 months. The secondary outcomes are weight change at 3 and 6 months, the proportion of participants achieving 5% and 10% weight loss at 12 months, and change in fat mass, haemoglobin A1c, low-density lipoprotein cholesterol and systolic and diastolic blood pressure at 12 months. Data will be analysed on the basis of intention to treat. Qualitative interviews on a subsample of patients and healthcare providers will assess their experiences of the weight loss programmes and identify factors affecting acceptability and adherence.

Ethics and dissemination: This study has been reviewed and approved by the National Health ServiceHealth Research Authority (HRA)Research Ethics Committee (Ref: SC/15/0337). The trial findings will be disseminated to academic and health professionals through presentations at meetings and peer-reviewed journals and to the public through the media. If the intervention is effective, the results will be communicated to policymakers and commissioners of weight management services.

Trial registration number: ISRCTN75092026.

Keywords: diet; obesity; primary care; weight loss.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Behavior Therapy
  • Diet, Reducing*
  • Energy Intake
  • Exercise*
  • Feasibility Studies
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Overweight / prevention & control*
  • Primary Health Care*
  • Randomized Controlled Trials as Topic / methods*
  • Referral and Consultation / statistics & numerical data*
  • Research Design*
  • Weight Loss
  • Weight Reduction Programs*